Individual
MRS. KELLY RACHEL BANKARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMSW
Contact information
Practice address
2500 W KOOTENAI ST, BOISE, ID 83705-2408
(208) 908-0500
Mailing address
4058 N HAWTHORNE WAY, BOISE, ID 83703-3923
(619) 994-1198
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
41894
ID
1041C0700X
Clinical Social Worker
—
CA
Other
Enumeration date
05/24/2007
Last updated
07/12/2022
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